Fracture outcomes related to persistence and compliance with oral bisphosphonates
Fracture outcomes related to persistence and compliance with oral bisphosphonates
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DOI：
10.1359/jbmr.080510
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发表时间：
2008-10-01
影响因子：
6.2
通讯作者：
van Staa, Tjeerd P.
中科院分区：
文献类型：
--
作者：
Gallagher, Arlene M.;Rietbrock, Stephan;van Staa, Tjeerd P.
低持久性对骨折风险的影响尚未完全解决。本研究的目的是描述使用氢膦酸盐的持久性和依从性，并评价其与骨折风险的相关性。全科医学研究数据库用于识别年龄≥ 18岁的患者，处方为阿仑膦酸钠或利塞膦酸钠。随访分为当前和过去使用的阶段。采用时间依赖性考克斯回归分析。研究人群包括44，531例患者：58.3%的患者继续双膦酸盐治疗>1年，23.6%的患者继续双膦酸盐治疗>5年。与既往使用过的磷酸盐相比，目前使用的髋关节/股骨骨折（校正相对率[RR]，0.78; 95% CI，0.64-0.94）和骨质疏松性骨折（RR，0.85：95%，CI，0.76-0.94）的风险较低。在治疗至少6个月的患者中观察到髋关节/股骨和腰椎骨折风险的最大降低，
The effects of low persistence on fracture risk have not been fully addressed. The objectives of this study were to describe the persistence and compliance with hisphosphonates and to evaluate the association with fracture risk. The General Practice Research database was used to identify patients >= 18 yr of age prescribed alendronate or risedronate. The follow-up was divided into periods of current and past use. Time-dependent Cox regression was used. The study population included 44,531 patients: 58.3% of the patients continued bisphosphonate treatment for >1 yr and 23.6%, for >5 yr. The risk of hip/femur fracture (adjusted relative rate [RR], 0.78; 95% CI, 0.64-0.94) and osteoporotic fracture (RR, 0.85: 95%, CI, 0.76-0.94) were lower with current compared with past hisphosphonate use. The largest reduction in hip/femur and osteoporotic fracture risk was observed in patients treated for at least 6 mo and no reduction in those treated for